Medical Payments Coverage in Auto Insurance

Physical injuries requiring varying degrees of medical attention that range from the superficial to the extensive are a common consequence of motor vehicle accidents. Medical payments provisions have been included in auto insurance policies in order to provide insured persons and occupants of covered vehicles reimbursement of payments made in obtaining such medical treatment after an accident.

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Medical payments provisions in motor vehicle insurance policies often take the form of policy clauses, separate from the policy’s liability coverage, under which an insurer agrees to pay up to a specified amount of medical expenses or funeral expenses incurred by an insured, another vehicle occupant, or sometimes a pedestrian, as the result of an accident involving a covered vehicle. Such policy provisions, which are sometimes dealt with in statutes regulating insurance, are in effect separate accident insurance policies for the benefit of the parties named in the medical payments coverage provisions. Because of limits on the amounts of coverage made available under medical payments provisions in auto insurance policies, attempts are often made to combine, or “stack,” multiple sources of potential medical payments coverage in order for a claimant to obtain more complete compensation for his or her loss. The existence and content of stacking or anti-stacking statutes, and the actual policy language involved, will determine whether such stacking of benefits will be permitted or whether an insurer will be able to prevent such stacking.

Because the business of insurance in the United States, including motor vehicle insurance, has historically been governed by the separate laws of each state rather than by a single unified body of federal law, the answers to questions about medical payments coverage under auto insurance policies will vary from state to state, and will be found in the state statutes regulating the business of insurance and in the decisions of courts on insurance-related matters.